Delay and failure in treatment seeking after first onset of mental disorders in the World Health Organization's World Mental Health Survey Initiative
Philip S Wang, Matthias Angermeyer, Guilherme Borges, Ronny Bruffaerts, Wai Tat Chiu, Giovanni DE Girolamo, John Fayyad, Oye Gureje, Josep Maria Haro, Yueqin Huang, Ronald C Kessler, Viviane Kovess, Daphna Levinson, Yoshibumi Nakane, Mark A Oakley Brown, Johan H Ormel, José Posada-Villa, Sergio Aguilar-Gaxiola, Jordi Alonso, Sing Lee, Steven Heeringa, Beth-Ellen Pennell, Somnath Chatterji, T Bedirhan Ustün, Philip S Wang, Matthias Angermeyer, Guilherme Borges, Ronny Bruffaerts, Wai Tat Chiu, Giovanni DE Girolamo, John Fayyad, Oye Gureje, Josep Maria Haro, Yueqin Huang, Ronald C Kessler, Viviane Kovess, Daphna Levinson, Yoshibumi Nakane, Mark A Oakley Brown, Johan H Ormel, José Posada-Villa, Sergio Aguilar-Gaxiola, Jordi Alonso, Sing Lee, Steven Heeringa, Beth-Ellen Pennell, Somnath Chatterji, T Bedirhan Ustün
Abstract
Data are presented on patterns of failure and delay in making initial treatment contact after first onset of a mental disorder in 15 countries in the World Health Organization (WHO)'s World Mental Health (WMH) Surveys. Representative face-to-face household surveys were conducted among 76,012 respondents aged 18 and older in Belgium, Colombia, France, Germany, Israel, Italy, Japan, Lebanon, Mexico, the Netherlands, New Zealand, Nigeria, People's Republic of China (Beijing and Shanghai), Spain, and the United States. The WHO Composite International Diagnostic Interview (CIDI) was used to assess lifetime DSM-IV anxiety, mood, and substance use disorders. Ages of onset for individual disorders and ages of first treatment contact for each disorder were used to calculate the extent of failure and delay in initial help seeking. The proportion of lifetime cases making treatment contact in the year of disorder onset ranged from 0.8 to 36.4% for anxiety disorders, from 6.0 to 52.1% for mood disorders, and from 0.9 to 18.6% for substance use disorders. By 50 years, the proportion of lifetime cases making treatment contact ranged from 15.2 to 95.0% for anxiety disorders, from 7.9 to 98.6% for mood disorders, and from 19.8 to 86.1% for substance use disorders. Median delays among cases eventually making contact ranged from 3.0 to 30.0 years for anxiety disorders, from 1.0 to 14.0 years for mood disorders, and from 6.0 to 18.0 years for substance use disorders. Failure and delays in treatment seeking were generally greater in developing countries, older cohorts, men, and cases with earlier ages of onset. These results show that failure and delays in initial help seeking are pervasive problems worldwide. Interventions to ensure prompt initial treatment contacts are needed to reduce the global burdens and hazards of untreated mental disorders.
Keywords: Treatment seeking; anxiety disorders; mood disorders; substance use disorders.
Source: PubMed